Body Psychotherapy

By Ger Murphy

Body Psychotherapy has been developing since 1944, with the publication of the first edition of Wilhelm Reich’s Character Analysis as a method of effecting psychological change by focus on one physical body as a supple­ment to working with verbal interchange. Body psychotherapy offers a perspective, a conceptual framework and a set of techniques to enrich the psychotherapists’ options in offering a framework for change to their clients. This perspective can augment, but not replace, other primary considerations of psychotherapeutic practice. In setting out an introductory sketch of the body psychotherapy perspective it is important to remind ourselves of these primary considerations:

1. Psychotherapy aims to help clients explore and reduce their internal emotional and psychological conflicts and thus allow them to alter their patterns of relating to themselves and others in their ordinary lives.

2. Psychotherapy happens in a relationship between two people. Focusing on this relationship as well as the presented external issues of the client, allows the client to see how he/she relates to another person and thus explore how this pattern of relating is replicated in the therapy relationship. This often involves exploring how the client can relate to the therapist in ways which are replicating significant relationships from early life. This is the concept of transference. The exploration offers the client the possibility of altering such patterns in the safety of the therapy setting as a precursor to altering them in their everyday lives.

3. Body psychotherapy can then only be used in the context of a therapy relationship which looks at the client’s transference. Also, body psycho­therapy techniques must only be used by the psychotherapist when they have explored their own counter transference reactions to the client. It is essential for the therapist to look at what feelings and reactions are stimulated in them by the client and to question themselves as to how using body oriented techniques may be an avoidance of these feelings and reactions. Only when such a procedure has been systematically undertaken can a decision be made to introduce a body psychotherapy approach. These methods can be as motivated by avoidance of contact in the therapist and client as by the wish to deepen such contact in a purposeful way in an effort to help the client. For this reason body psychotherapy techniques should always continue to go hand in hand with continued exploration of the trans­ference and counter transference. For as it is important to focus on the way and the meaning of our clients’ verbal communication as well as its content, so it is important to be cognisant of the significance of using body techniques in our work.

Finally, it is for these reasons that I believe body oriented work needs to come into a psychotherapeutic relationship only after a good deal of the relationship building work has been undertaken. This allows the psycho­therapist to make decisions as to the developmental position and degree of inner stability of the client. With clients who are especially vulnerable and chaotic in their lives, much ego-building work (including practical assistance in exploring how they manage themselves in their work and personal lives) needs to be undertaken prior to the introduction of a body oriented approach. In fact with some clients it may not, at any stage of the therapy, be appropriate to introduce such an approach.

Body psychotherapy can be viewed with alarm (by perspective clients), suspicion (by therapists of other orientations) or credo (by practitioners). My aim in this brief article is to demystify body psychotherapy somewhat, to explore its development and practice and to offer some indications and contra indications as to its appropriate use.

The term Body Psychotherapy can be defined broadly as an approach to the healing of psychological distress which focuses on the physical body of the client as a gateway to change in thought, emotion and behavioural patterns. It does not, therefore, include massage, reflexology and other com­plimentary medical and alternative therapy practices. These practices focus on specific physical manipulation/treatment and do not include the depth of focus on:

1. The interpersonal dynamic between client and psychotherapist (including transference).
2. The unconscious patterns, beliefs and forces which often play a large part in psychological distress.
3. The patterns of intrapersonal and interpersonal interaction that are un­satisfactory to the client and which she/he has come into therapy to change. Body Psychotherapy, however, is still a term used to describe a wide con­tinuum of interventions. On the one hand it is to sit and talk with clients about their concerns and to draw attention to their own “felt sense”.

John Welwood in Befriending Emotion speaks of our feeling life as “a whole spectrum of expressions from global and diffuse to sharp and intense … which could be pictured in a cone shape, with a broad and deep base which gets more narrow and intense as it peaks”.

15 p 5 Emotions

Emotions are more intense forms of feeling, such as the peak emotion or grief arising out of a feeling of sadness. Welwood says:

“The distinguishing characteristic of emotion is that it dominates our attention and cannot be ignored, while a feeling can remain in the back­ground of awareness”.

Often clients come to psychotherapy vulnerable and anxious. This vulner­ability when discussed, often arises when their self concept (or view of what kind of person they are) is at variance with their inner experience. For example, the client who believes herself to be generous and forgiving, is finding parts of herself where she senses the emotion of hatred or greed. Such emotion often gives rise to discomfort and a sense of threat. The threat, however, appears to come from the inside. In these situations the typical defensive responses may be to busy oneself with other things, deny the emotion or believe that it is others around you who experience the un­wanted emotion as in projection: “it’s not me who is angry but you …”

When in psychotherapy we can risk giving space to the strong emotion and discover the feelings and felt senses (often contradictory) which are underneath, we can being to get relief and understanding.

This allows clients to move to a deeper knowing and contact with themselves and often helps them allow change. This would be underpinned by a paradoxical theory of change often linked with Gestalt Psychotherapy: i.e. to change, I must be more of what I am first, then change will occur.

Such a concept of psychotherapeutic change is underlined by four important and fundamentally related principles which seem to underlie most body psychotherapy:

1. There is a natural self regulating process inherent to existence. This means that it is believed that the child and adult attempts to find the most satisfactory way of taking care of itself and others.
2. Taking care of oneself begins by taking responsibility for how one is not taking care of oneself.
3. The human being exists in an environment and so peace of mind is partially a function of accepting what fate bestows upon us all, including our inability to transform ourselves into our conceptualised ideals.
4. The human organism is capable of disowning, misapprehending or distorting knowledge of its experience and behaviour.*

This type of psychotherapeutic work is also close to the technique of focusing, though not as strictly mapped out by Gendlin (see review, this issue).

This form of body psychotherapy does not involve any physical contact by the psychotherapist and does not prescribe any specific direction to the client, except to encourage awareness of what is already imminent. Further along the continuum we find an approach which specifically encourages dir­ect awareness of body parts and body language during sessions e.g. “when you speak of your loving relationship with your husband you constantly clench your fists”. In this the attention is directed to the unconscious com­munication by the client of often unacceptable emotion. This can then be en­couraged into awareness and can be allowed expression. This may take the form of inviting the client to give the hand a voice and see what it would say, or encouraging the physical expression in symbolic form of the desired but forbidden action: e.g. client may feel unsure about giving permission to the angry feeling but with therapist acting as auxiliary ego and giving first permission, may be able to allow the fist to hit out perhaps at a cushion. This action, while initially releasing repressed feeling, can also moderate the rule which the client has taken into him/herself from parental/authority figures that strong negative emotion is not tolerable. The consequence of such introjectcd (i.e. taken in) rules is often the turning of the feeling on oneself exhibiting itself in many forms of symptoms – emotional, depression, self-disgust etc. – as well as contributing to physical symptoms such as colitis, ulcers or teeth grinding.

We now move further along the continuum that I believe can be seen as relevant therapeutic intervention under the term Body Psychotherapy. To do so we need to focus briefly on its history. Body Psychotherapy grew out of the work of Wilhelm Reich. Reich was a classical psychoanalyst studying under Freud in the early years of psychotherapy. In this period 1880-1895, when Freud had first attempted to account for hysteria, he saw the hysteric neurosis as having originated in the inability of the client to discharge strong affect, following particular trauma, often from early life. He postulated that if such affect could be discharged through catharsis or strong emotional expression, then the symptom would disappear. By the 1920s, Freud had long abandoned such a biologically grounded thesis in favour of a more psychological approach. He now postulated that the psychic structures of super-ego (or parent in Transactional Analysis terms) and the Id (child in Transactional Analysis ) constantly battled for space in the mental/emotional life of the individual. These forces were mediated by the third psychic structure: the ego. The ego attempted to deal with the outside world and gain a balance between instinctual gratification (needs/urges) and internalized authority prohibition (“shoulds/oughts”). Therefore the stage of psychological distress and thereby the focus of change had moved squarely from body to mind.

Reich had difficulty with the use of analytic procedures in some cases and was seeking ways of understanding and working through client resistance. He did not follow Freud but, instead, moved further along a physically oriented route. He claimed that the person developed as a relatively stable psychic compromise resulting from this three-cornered struggle, and this would be seen as the character of the individual. Here certain traits, neurotic tendencies and patterns would be employed to keep anxiety at bay. This was seen as the neurotic compromise. Reich saw physical dimensions to char­acter. He believed that in moving through the developmental cycles of child­hood, children armoured themselves physically as well as psychologically.

Here I must digress in order to define what I mean by the concept of armouring. The body is controlled by two nervous systems: the voluntary and the autonomic. The voluntary systems control muscular movements and the skin and sense sensations. The autonomic nervous system is of primary concern to the Reichian approach. For it is this system which controls pulse rate, digestive movement, breath etc., and there are two components: the sympathetic and the parasympathetic. The sympathetic or, as it is sometimes called, the fight/flight mechanism, mobilizes us for action when under threat. This process releases hormones which encourage a preparedness for action in the body in danger. The parasympathetic releases hormones to bring about relaxation. Where a child is under physical or emotional threat, certain mobilization as described above will ensue. However, should such threat continue the state of preparedness will become chronic and go out of awareness. It will then be experienced as normal posture. This armour in physical posture will join with the character armour adopted by the child as he/she grows to live as successfully as possible with the painful situation. Thus, the history of the individual is stamped on the body as structure. A differential diagnosis of character from a physical and psychological per­spective could now be undertaken and Reich and others outline a number of predominant character types: schizoid, hysteric, oral, masochistic etc. An understanding of the genesis and development of each character type would orient the psychotherapist to different interventions. The differentiation of type can be made with reference to a number of parameters, such as boundary, charge and grounding. For example, I can explore my physical character in terms of grounding. Am I undergrounded: “up in the air”, fanciful, heady, unrealistic, wispish in movement? Or am I overgrounded: “ploddy”, “stuck”, “unadventurish”? These elements can be worked on by exploring how I use my body, exploring the use of different physical stances as a way of experiencing and anchoring change in the body mind.

Later Boadella and others developed typologies which offer maps of character on these dimensions. Boadella speaks of there being three primary modes of body psychotherapy which he calls centering, grounding and facing. Centering relates primarily to the “rebalancing of the autonomic nervous system thus recovering emotional balance and harmonious breath­ing”. In this we work with how the person uses their emotional body, how they compulsively repress or express their feelings.

Grounding is concerned with establishing a good relationship between the voluntary, semi-voluntary and involuntary modes of movement and with recreating a more appropriate muscle tone. How we hold ourselves reveals much about how we stand in the world, how we hold our ground and how we feel about ourselves. This work involves movement and standing in an aware way.

Finally, facing relates to how we face the world. How the individual allows information in through the senses. Is he under-bounded, “thin skinned” and over sensitive? The work in this area is with eye contact and reaction to touch and voice contact. In this then we see a three-dimensional model: how we relate to the ground, to ourselves and to the other.

Alongside the work of Boadella and the pioneering work of Reich there arose the work of Lowen and Pierakos. Lowen looked at specific inter­ventions and exercises to change the equilibrium of charge and discharge of energy, normally held in check by the armour. Exercises were devised which changed the breathing pattern and movement pattern. Such changes lead to the body’s habitual level of charge being altered, and thus lead to release of blocked feeling. This practice is now known as bioenergetics.

So far I have summarily reviewed a range of body psychotherapy inter­ventions which differ in the level of perscriptiveness on the part of the psychotherapist. They range from the relative non-directiveness of exploring the felt sense to the strongly structured exercise of bioenergetics. My own feeling is that body psychotherapy offers a range of powerful interventions which can be very useful as part of a therapeutic relationship. I emphasise that these interventions must be in the context of a relationship which explores the contact between therapist and client, both in the here and now and in its transference dimensions. For competent use of such techniques a psychotherapist needs training and experience of an integrative nature which focuses on the psychotherapeutic relationship in its transferential (Analytic), and its here and now dimensions (Gestalt and Client Centered Psychotherapy), as well as training in the specific procedures of body psychotherapy. Working with the body aims to foster reintegration in the person and demands the reintegration of the person of the therapist through their being able to hold a variety of theoretical perspectives.

*(In Fagen J. & Shepherd. Eds. Gestalt Therapy Now. Palo Alto. Science & Behavioural Books 1970)

For further discussion on change see Beisser: The Paradoxical Theory of Change.

Bibliography

Baker, Elsworth Man in the Trap: New York (1967)

Boadella, David Lifestreams: Routledge Kegan Paul (1986)

Boadella, D. William Reich: The Evolution of his Work. Vision Press London (1973)

Boadella, D. In the Wake of Reich: Conventure Limited London (1976)

Dychtwald, Ken Body Mind: Tarcher Inc. Distrib. by St. Martin’s Press New York (1977)

Lake, Frank Clinical Theology: London (1966)

Keleman, Stanley Emotional Anatomy: Centre Press Berkeley (1985)

Keleman, S. Bonding: Centre Press (1985)

Marcus, Eric Gestalt Therapy & Beyond: Meta Publications California (1979)

Lowen D. The Language of the Body. Collier Books (1958)

Lowen D. Depression and the Body. New York (1972)

Reich, Wilhelm Character Analysis: Fardar Strams & Giroux New York (1945-83)

Welwood J. Ed. Awakening the Heart: New Science Library Boston (1983)

Ger Murphy works as a psychotherapist, supervisor and trainer at the Creative Counselling Centre, Dublin.